Mentor Visitation Form
Please fill this out every time you meet with a student one-on-one or group settings outside of a JU4Y organized event.
Mentor Name *
Your answer
Mentee Name *
Your answer
Date of Visitation *
MM
/
DD
/
YYYY
Time you met *
Time
:
Time you finished *
Time
:
Location of Visit *
Your answer
Nature of Visit *
Your answer
What area/s were your main focus? *
Check all that apply.
Required
What milestone did you check of your list this month?
Check all that apply.
Any questions/concerns/successes/suggestions you would like us to know about your mentee, your relationship or anything else going on in/outside the program? *
Your answer
Do you need extra resources/help/support for anything? *
Your answer
Send me a copy of my response *
Submit
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